Question 1

What is HCPCS code G9678?

Accepted Answer

HCPCS code G9678 is "Oncology care model service". Oncology care model (ocm) monthly enhanced oncology services (meos) payment for ocm enhanced services.  g9678 payments may only be made to ocm practitioners for ocm beneficiaries for the furnishment of enhanced services as defined in the ocm participation agreement

Question 2

What category is G9678 in?

Accepted Answer

G9678 belongs to HCPCS Category G (Procedures/Professional Services).

Question 3

When should I use HCPCS code G9678?

Accepted Answer

Use G9678 when billing for oncology care model service. HCPCS Level II codes like this are used for items and services not covered by CPT codes, including medical supplies, equipment, drugs administered in clinical settings, and certain healthcare services.

Question 4

Is G9678 covered by Medicare?

Accepted Answer

Coverage for G9678 (Oncology care model service) depends on medical necessity and specific Medicare guidelines. Check the applicable Local Coverage Determination (LCD) or National Coverage Determination (NCD) for detailed coverage criteria. Private insurers may have different coverage policies.

Question 5

What documentation is required for G9678?

Accepted Answer

Documentation for G9678 should include: the medical necessity for the item or service, supporting diagnosis codes (ICD-10), prescription or order from the treating physician, and proof that the item meets quality standards. Some items may require additional documentation like a Certificate of Medical Necessity (CMN).